tbuckley/cabot-search huggingface dataset:
AB1470 DOES TESTING FOR SAA IS MORE BENEFICIAL THAN CRP FOR THE FOLLOW-UP OF PATIENTS WITH FMF?
Authors: M. Oztas, O. Selvi, B. Ergezen, H. Ozdogan, S. Ugurlu
Journal: Annals of the Rheumatic Diseases (2022)

Background In order to follow subclinical inflammation and adjust the therapy for an optimal disease control, clinicians seek for readily accessible, affordable and reproducible markers. C reactive protein (CRP) is widely used for this purpose. Some suggest that the Serum Amyloid A (SAA) is preferable to CRP as a biomarker of inflammation in FMF patients 1 . Objectives To evaluate and to compare the sensitivity of the serum SAA and CRP levels in FMF patients. Methods Serum SAA and CRP levels were measured in 45 patients. 153 measurements from 28 patients with M694V homozygous mutation and 74 measurements from 17 patients with M694V heterozygous mutation were obtained during a mean follow-up of 1 year. For the analysis, the folds of normal CRP and SAA values were used for correlation. Serum levels of the given markers were measured with nephelometric kits (normal CRP levels &lt; 5 mg/L and SAA levels &lt; 6,8 mg/L). More than one and half fold increasement of CRP and SAA was defined as an active inflammation. The correlation coefficients and their significance were calculated using the Spearman test. Results Except a patient, all patients in whole cohort were on prophylactic colchicine. Among 28 patients with M694V homozygous mutation, a patient with adalimumab, 12 (42,8%) patients with anti-IL-1 regimens. Of the 17 patients with M694V heterozygous mutation, four (23,5%) were under anti-IL-1 treatment. There was a total of 227 measurements of CRP and SAA from 45 patients. Twenty-five (11%) measurements were obtained during the attack period in and the remaining 202 measurements were collected in attack free period. Figure 1 demonstrates the correlation between CRP and SAA levels (r=0.8, p&lt; 0,001). Both acute phase reactants were increased in 72 (31,7%) measurements, while in 13 (5,7%) CRP level was high but SAA level was normal and in 31 (13,6%) SAA level was high however CRP level was within the normal limits. The vast majority (30:31) of high SAA with normal CRP levels were observed in patients with M694V homozgous mutation. The mean increase in CRP of the entire cohort was 2,06 ± 3,34-fold, whereas mean increase in SAA was 6,23 ± 15,04-fold of the normal levels. Figure 1. The folds of the serum CRP and SAA levels in the entire cohort. Conclusion According to our results, serial testing of SAA does not provide any additional advantages over CRP. Readily accessible and affordable bio-marker CRP seems to be sufficient for follow-up of patients with FMF. References [1]DOI: 10.1038/nrrheum.2010.181 Disclosure of Interests None declared
AB1216 TUBERCULOUS, BRUCELLAR AND PYOGENIC SPONDYLODISCITIS: A DESCRIPTIVE AND COMPARATIVE STUDY OF 70 CASES
Authors: N. Ben Chekaya, F. Fhima, M. Ghali, A. Ben Salem, S. Zrour, I. Bejia, M. Touzi, M. Jguirim, N. Bergaoui
Journal: Annals of the Rheumatic Diseases (2022)

Background Infection spondylodiscitis is a serious infectious disease which involves intervertebral disc and its adjacent vertebral bodies but later may also extend into the the adjacent neural structures. Early diagnosis and identifing the causative agent seem critical in term of prognosis. Objectives To describe and to compare the clinical, biological and radiological features of tuberculous (TS), brucellar (BS) and pyogenic spondylodiscitis (PS). Methods A retrospective monocentric study involving 70 cases of infectious spondylodiscitis admitted between January 2009 and August 2019 at our rheumatology department. Clinical, laboratory and radiological data of the patients were collected. Results Of these 70 patients, 18 (25.7%) had TS, 8 (11.4%) BS and 44(62.9%) PS. There were 37 women (52.9%) and 33 men (47.1%). The age of the patients ranged from 12 to 82 years, with a mean of (SD±) 54± 15,23 years. The patients with TS were younger than those with PS (p=0.0016). Of our cases, 67.1% had comorbid chronic diseases such as predominantly renal failure and diabetes. The median diagnostic delay (MDD) in our series was 120,180 and 30 days for TS, BS and PS respectively (p=0.004).All of the patients included in this study suffered from pain, 30 of these had fever and 19 had night sweats. Radiculalgia was found in 50% of cases and 8.6% of them had a neurological deficit. There were no significant differences those clinical features between the groups. In view of laboratory findings, increased erytrocyte sedimentation rate (ESR) was detected in 82.9%, C-reactive protein(CRP) positivity in 84.3% and hyperleukocytosis in 33.3% of patients. ESR and CRP levels were significantly higher in PS patients when compared with TS cases (p=0.005; P=0.006, respectively). Standard X-rays showed abnormalities suggestive of spondylodiscitis in 78.6% of cases. Computed tomography and Spinal magnetic resonance imaging were performed respectively in 52.9% and 63% of cases and were pathological in all cases. A great majority of the patients had involvement at only one vertebrae level (70%). The most frequently affected level, were the thoracic (33.3%), the lombosacral (100%) and the lombar (38.6%) segment in the TS, BS and PS respectively. In BS the lombosacral segment was significantly the most frequently affected level (p&lt;0.0037). The intervertebral disc narrowing was observed in 87.3% of patients. Paravertebral or epidural masses were present respectively in 53.5% and 86.7% of TS, versus 14.3% and 71.4% of BS, and 46.3% and 80.5% of PS, there were no significant differences between the groups. Conclusion There are significant clinical, biological and radiological differences between TS, BS and PS. The presence of back pain, fever, moderate elevation of inflammatory markers with thoracic radiological involvement was suggestive of tuberculous spinal infection. Disclosure of Interests None declared
AB0749 Anti-PM/Scl 75 and Anti-PM/Scl 100 antibodies: does the number matter?
Authors: B. Santos, A. Basto, A. Reboredo, A. Barcelos
Journal: Annals of the Rheumatic Diseases (2022)

Background Anti-polymyositis/Scl (PM/Scl) antibodies have been associated to systemic sclerosis (SSc), PM and PM-SSc overlap syndrome. Although not specific and with some uncertainty about their true prevalence, they have been linked to the clinical presentation and prognosis of SSc rather than traditionally related impact of the extent of the cutaneous involvement 12 . Objectives The aim of this study is to describe the demographic, clinical and laboratorial data associated with the presence of anti-PM/Scl and to compare the differences against the two major antigenic components: 100 and 75 kDa proteins (anti-PM/Scl-75 and anti-PM/Scl-100). Methods A retrospective study including patients with positive anti-PM/Scl antibody followed in rheumatology department from January 2017 to December 2021 were analyzed. Demographic, clinical, immunological and nailfold capillaroscopy data at presentation and during follow-up were collected. Descriptive, Student’s t and Fisher test were estimated. Results Fifty six patients were positive for anti-PM/Scl antibodies. Of these, 38 (68%) were female with a median age at presentation of symptoms was 47 ± 16 years. Asymptomatic carrier of anti-PM/Scl75 and anti-PM/Scl100 were present in 15 (27%) and 7 (13%) of the patients, respectively. SSc and PM were the diagnosis most found, 34% and 9%, respectively. Arthralgias/Arthritis and Raynaud phenomenon (RP) were the first clinical features most presented followed by respiratory symptoms and constitutional symptoms. Relating to cumulative organ complications, peripheral vascular involvement was the most affected (RP, 30%) followed by musculoskeletal (MSK) and lung (interstitial lung disease - ILD, 21%) and skin involvement (limited cutaneous form, 20%). All patients were positive to antinuclear antibodies by indirect immunofluorescence. Comparing patients with positive anti-PM-Scl75 and anti-PM-Scl100 showed a statistically significant difference at the presence of RP (as first or cumulative manifestation) and early pattern on nailfold capillaroscopy (p= 0.049 and p=0.039, respectively). A statistically significant difference was also found in an asymptomatic patient (p&lt;0.001) – Table 1. Conclusion Anti-PM/Scl antibodies are frequently associated to MSK and RP symptoms as first and cumulative clinical manifestations followed by ILD and limited cutaneous form of SSc. Between anti-PM/Scl 75 and 100 serological profile, anti-PM/Scl100 is more associated to RP and abnormal nailfold capillaroscopy pattern. References [1]Wielosz E, Dryglewska M, Majdan M. The prevalence and significance of anti-PM/Scl antibodies in systemic sclerosis. Ann Agric Environ Med. 2021 Mar 18;28(1):189-192. [2]Iniesta Arandia N, Espinosa G, Guillén Del Castillo A et al. Anti-Polymyositis/Scl Antibodies in Systemic Sclerosis: Clinical Associations in a Multicentric Spanish Cohort and Review of the Literature. J Clin Rheumatol. 2022 Jan 1;28(1):e180-e188. Disclosure of Interests None declared
Commentary
Authors: Haruhiro Inoue
Journal: Endoscopy (2022)

I read this E-Video article with considerable interest. As shown in the video, the authors used blunt dissection in creating the submucosal tunnel in a peroral endoscopic myotomy (POEM) procedure. Following mucosal incision and entry of the endoscope into the submucosal space and some initial electrodissection, blunt dissection using the tip of the distal attachment to the endoscope (the transparent cap) was then used effectively to establish the submucosal tunnel. Then when tunneling close to the lower esophageal sphincter, blunt dissection was combined with electrodissection to avoid injury to the mucosal flap. In general, blunt dissection can be easily accomplished in porcine models, but it is not always so easy in clinical cases. Actually, in this video blunt dissection was carried out in combination with knife cutting when hard submucosal tissue was encountered. Direct endoscopic visual control, as with any endoscopic procedure, is most important to achieve safe and effective submucosal tunneling in the appropriate layer.
AB1234 RHEUMATIC MASKS OF ONCOLOGICAL DISEASES IN CHILDREN
Authors: N. Zhuravleva, T. Smirnova, O. Sharapova, L. Gerasimova, L. Markelova
Journal: Annals of the Rheumatic Diseases (2022)

Background Early diagnosis of oncological pathology, which can occur under the guise of other diseases, including rheumatic diseases, is relevant. Objectives To analyze the features of the course of rheumatic masks of oncological diseases in children. Methods An analysis was made of the features of the course of oncological diseases in 15 children (5 girls and 10 boys) aged 3 to 15 years, hospitalized in the rheumatology department of the Republican Children’s Clinical Hospital for the period from 2012 to 2021. Results The disease was manifested by fever in 11 of 15 patients. Complaints when contacting a rheumatologist: pain and limitation of movement in the joints (15/15), in the lumbar region (2/15), weakness (8/15), abdominal pain (3/15), vomiting (2/15), myalgia (3/15), hair loss (1/15), nosebleeds (1/15). On physical examination: peripheral lymphadenopathy (4/15), periorbital shadows, pallor (10/15), lupus-like erythema on the face (1/15), joint tenderness on palpation and movement (11/15), joint deformity (2/15). 15), spinal rigidity (3/15), hepatosplenomegaly (5/15). On laboratory examination: anemia (7/15), leukopenia (3/15), leukocytosis (4/15), thrombocytopenia (3/15), thrombocytosis (1/15), pancytopenia (1/15), hypoalbuminemia (2/15). 15), increase in ESR (11/15), CRP (11/15), LDH (4/15), AST, ALT (3/15). Established preliminary clinical diagnoses: juvenile rheumatoid arthritis (10/15), systemic lupus erythematosus (2/15), dermatomyositis (1/15), reactive arthropathy (1/15), fever of unknown origin (1/17). Appointed: NSAIDs (8/16), glucocorticoids (9/15), methotrexate (5/15), cyclophosphamide (1/15). An oncological search was carried out. The following diagnoses were verified: stage 4 neuroblastoma (4/15), acute lymphoblastic leukemia (5/15), stage 4 B-large cell lymphosarcoma (1/15), stage 4 B-lymphoblastic lymphoma/leukemia (1/15), T-cell lymphoma (1/15), stage 3 glioma (1/15), malignant histiocytoma (1/15), brain tumor (1/15). Conclusion Oncological diseases in children can occur under the guise of rheumatic diseases. Immunosuppressants and glucocorticoids mask the true clinical picture of the neoplasm and prevent early diagnosis. Disclosure of Interests None declared
POS1495-HPR COVID-19, INFLUENZA AND PNEUMOCOCCUS VACCINATION UPTAKE IN PATIENTS WITH RHEUMATIC DISEASE: A PROSPECTIVE AUDIT
Authors: R. Mazumder, R. Yamin, M. Roberts, K. Afridi, E. Ntatsaki
Journal: Annals of the Rheumatic Diseases (2022)

Background Patients with autoimmune inflammatory rheumatic diseases are susceptible to infections. This could be attributed to theimmunosuppressive effect of the underlying condition or the use of immunomodulatory medications. According to the Department of Health guidelines inthe UK and the European League Against Rheumatism (EULAR), patients who are immunosuppressed should be vaccinated against influenza and pneumococcal infection, as well as COVID-19 infection. Objectives Our aim was to explore the Pneumococcal, Influenza and COVID-19 vaccination uptake of our patients with different autoimmune inflammatory rheumatological conditions. In addition, to assess the side effects profile and the status of their underlying rheumatological diseases following COVID-19 vaccination. Methods We undertook a prospective audit of consecutive patients with regards to their vaccination update for influenza, pneumococcus, and COVID-19, utilizing a standard questionnaire and compared the results to our 2017 data. Results Some 81% of patients received the influenza vaccination (compared to 47% in 2017) representing a 172% improvement, p&lt;0.001. Some 53% received the pneumococcus vaccination compared to 28% in 2017, indicating a 185% improvement, p=0.003. With regards to COVID-19 vaccination, 98/101(97%) of eligible patients received at least one dose and 66% received two doses. 47% received Astra Zeneca, 52% Pfizer and 1% unsure. 46% of patients mentioned, no one specifically discussed the COVID vaccine with them - got information via SMS/ from media, However, 37% of patients were informed by GP Doctor/ Nurse, 14% from the person giving the vaccine, and 7% from specialist hospital doctor. Safety concerns were indicated by all 3 patients who deferred vaccination. Most side-effects were observed following the first dose (74 patients) vs. the second dose (13 patients) and were mainly mild (66%), but also moderate (19%) and severe (15%). The sore arm was the commonest side-effect, whilst the majority of side-effects resolved within two days. Crucially, 28% reported a flare of the rheumatological condition following the vaccination. No patients receiving at least one dose were diagnosed with COVID-19 infection subsequently. Conclusion Vaccination rates for influenza and pneumococcus have improved substantially since 2017, although the population with rheumatic diseases still has low uptake in pneumococcal vaccination. The COVID-19 vaccination uptake has been extremely high in this cohort. Disclosure of Interests None declared
Emergence of SARS-CoV-2 Omicron lineages BA.4 and BA.5 in South Africa
Authors: Houriiyah Tegally, Monika Moir, Josie Everatt, Marta Giovanetti, Cathrine Scheepers, Eduan Wilkinson, Kathleen Subramoney, Zinhle Makatini, Sikhulile Moyo, Daniel G. Amoako, Cheryl Baxter, Christian L. Althaus, Ugochukwu J. Anyaneji, Dikeledi Kekana, Raquel Viana, Jennifer Giandhari, Richard J. Lessells, Tongai Maponga, Dorcas Maruapula, Wonderful Choga, Mogomotsi Matshaba, Mpaphi B. Mbulawa, Nokukhanya Msomi, Armand Phillip Bester, Mathilda Claassen, Deelan Doolabh, Innocent Mudau, Nokuzola Mbhele, Susan Engelbrecht, Dominique Goedhals, Diana Hardie, Nei-Yuan Hsiao, Arash Iranzadeh, Arshad Ismail, Rageema Joseph, Arisha Maharaj, Boitshoko Mahlangu, Kamela Mahlakwane, Ashlyn Davis, Gert Marais, Koleka Mlisana, Anele Mnguni, Thabo Mohale, Gerald Motsatsi, Peter Mwangi, Noxolo Ntuli, Martin Nyaga, Luicer Olubayo, Botshelo Radibe, Yajna Ramphal, Upasana Ramphal, Wilhelmina Strasheim, Naume Tebeila, Stephanie van Wyk, Shannon Wilson, Alexander G. Lucaci, Steven Weaver, Akhil Maharaj, Yusasha Pillay, Michaela Davids, Adriano Mendes, Simnikiwe Mayaphi, Yeshnee Naidoo, Sureshnee Pillay, Tomasz Janusz Sanko, James E. San, Lesley Scott, Lavanya Singh, Nonkululeko A. Magini, Pamela Smith-Lawrence, Wendy Stevens, Graeme Dor, Derek Tshiabuila, Nicole Wolter, Wolfgang Preiser, Florette K. Treurnicht, Marietjie Venter, Georginah Chiloane, Caitlyn McIntyre, Aine O’Toole, Christopher Ruis, Thomas P. Peacock, Cornelius Roemer, Sergei L. Kosakovsky Pond, Carolyn Williamson, Oliver G. Pybus, Jinal N. Bhiman, Allison Glass, Darren P. Martin, Ben Jackson, Andrew Rambaut, Oluwakemi Laguda-Akingba, Simani Gaseitsiwe, Anne von Gottberg, Tulio de Oliveira
Journal: Nature Medicine (2022)

Abstract Three lineages (BA.1, BA.2 and BA.3) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant of concern predominantly drove South Africa’s fourth Coronavirus Disease 2019 (COVID-19) wave. We have now identified two new lineages, BA.4 and BA.5, responsible for a fifth wave of infections. The spike proteins of BA.4 and BA.5 are identical, and similar to BA.2 except for the addition of 69–70 deletion (present in the Alpha variant and the BA.1 lineage), L452R (present in the Delta variant), F486V and the wild-type amino acid at Q493. The two lineages differ only outside of the spike region. The 69–70 deletion in spike allows these lineages to be identified by the proxy marker of S-gene target failure, on the background of variants not possessing this feature. BA.4 and BA.5 have rapidly replaced BA.2, reaching more than 50% of sequenced cases in South Africa by the first week of April 2022. Using a multinomial logistic regression model, we estimated growth advantages for BA.4 and BA.5 of 0.08 (95% confidence interval (CI): 0.08–0.09) and 0.10 (95% CI: 0.09–0.11) per day, respectively, over BA.2 in South Africa. The continued discovery of genetically diverse Omicron lineages points to the hypothesis that a discrete reservoir, such as human chronic infections and/or animal hosts, is potentially contributing to further evolution and dispersal of the virus.
AB0465 COMPARISON OF ULTRASOUND STRUCTURE CHANGES OF SALIVARY GLANDS IN PATIENTS WITH PRIMARY SJÖGREN’S SYNDROME WITH POSITIVE AND NEGATIVE ANTICENTROMERE ANTIBODIES
Authors: J. Khvan, A. Torgashina, E. Sokol, B. Chalcev
Journal: Annals of the Rheumatic Diseases (2022)

Background Apart from anti-Ro and/or anti-La positive primary Sjögren’s syndrome (pSS), there is a unique subtype of pSS with anticentromere antibodies (ACA). At the present time salivary gland ultrasonography (SGUS) is widely used to assess the structure of the salivary glands in pSS, but there are few publications about SGUS changes in ACA-positive patients [1]. Objectives To investigate SGUS changes in ACA (ACA+) positive pSS patients and compare with ACA-negative (ACA–). Methods We examined 141 patients with pSS, including 103 ACA– patients (pSS-ACA–) with the mean age 49,8 ± 14,1 years and 38 ACA+ positive (pSS-ACA+) with the mean age 59,1 ± 10,2 years. All patients underwent standard examination for the diagnosis of pSS (stomatological, ophthalmological, immunological), and SGUS performed using GE LOGIQ 9 of two parotid and two submandibular glands. Ultrasound images were evaluated with the OMERACT SGUS scoring system (SGUS SS) from grades 0 to 3 [2]. Statistical analyses (chi-squared test, p &lt;0.05) were performed using STATISTICA version 12. Results Characteristics of patients with pSS-ACA+ and pSS-ACA– are presented in Table 1. Table 1. Parameters ACA– ACA+ N % N % Oral dryness 86 83,5 36 94,7 Ocular dryness 76 73,8 30 78,9 Enlargement of parotid salivary glands 36 34,9 7 18,4 Recurrent parotitis 23 22,3 7 60,5 ANA ≥1:320 103 100 38 100 Stimulated saliva flow test &lt; 2.5 ml/5 min 65 63,1 30 78,9 Sialectasia on parotid sialography 103 100 38 100 Stimulated Schirmer’s test &lt;10 mm/5 min 67 65,0 26 68,4 Tear breakup time &lt;10 seconds 59 57,3 20 52,6 Focus score ≥ 1foci/4 mm2 94 91,3 12/13 92,3 MALT-lymphomas 8 7,7 5 13,1 Characteristics of SGUS SS in pSS-ACA+ and pSS-ACA– are shown in Figure 1. Figure 1. We did not find significant differences when comparing SGUS SS in patients with pSS-ACA+ and pSS-ACA–. Conclusion We did not find significant differences in SGUS and SGUS SS in patients with pSS-ACA+ and pSS-ACA–. References FURS-2022-003 [1]Min HK, Kim SH, Park Y, et al. Ultrasonographic characteristics of major salivary glands in anti-centromere antibody-positive primary Sjögren’s syndrome. PLoS One. 2021;16(11):e0259519. Published 2021 Nov 3. doi:10.1371/journal.pone.0259519 [2]Jousse-Joulin, Sandrine et al. “Video clip assessment of a salivary gland ultrasound scoring system in Sjögren’s syndrome using consensual definitions: an OMERACT ultrasound working group reliability exercise.” Annals of the rheumatic diseases vol. 78,7 (2019): 967-973. https://doi:10.1136/annrheumdis-2019-215024 Disclosure of Interests None declared
AB0085 TIGLYLCARNITINE AS KEY FACTORS IN LIVER–JOINT AXIS
Authors: H. Wang, Y. Zhang
Journal: Annals of the Rheumatic Diseases (2022)

Background Gut microbiota could promote RA progression metabolites mediated gut–joint axis [1]. We previously reported that liver metabolism has a close linkage with Rheumatoid arthritis (RA) [2]. However, the inter-relational mechanisms between liver and joint are still unclear. Objectives This article aimed to explore the shared metabolites signatures of liver, plasma and joint in RA. Methods We integrated multiomics datasets metabolites of liver and plasma from in the healthy group (n=10) and CIA group (n=10), and metabolites of knee-joint fluid (synovial fluid) from 40 participants in osteoarthritis (OA) group (n=20) and RA group (n=20). The Weighted Gene Co-Expression Network Analysis (WGCNA) was used to identify the co-expression modules related to liver, plasma and joint. Results The blue modules were negativelycorrelated with CIA (r =-0.74, p &lt;0.001), included 200 liver metabolites. The black modules were positively correlated with CIA (r = 0.63, p &lt;0.001), included 78 plasma metabolites. The yellow modules were positively correlated with RA (r = 0.53, p =0.008), included 55 synovial fluid metabolites. There were only 1 metabolite (Tiglylcarnitine) overlapped in RA-related module of liver, plasma and joint. Conclusion Tiglylcarnitine may be the key factors to liver–joint axis. References [1]Zhao Y, Cheng M, Zou L, et al. Hidden link in gut-joint axis: gut microbes promote rheumatoid arthritis at early stage by enhancing ascorbate degradation [published online ahead of print, 2021 Jul 8]. Gut. 2021;gutjnl-2021-325209. doi:10.1136/gutjnl-2021-325209 [2]Wang H, Zhang N, Fang K, Chang X. 2-Deoxy-D-glucose Alleviates Collagen-Induced Arthritis of Rats and Is Accompanied by Metabolic Regulation of the Spleen and Liver. Front Immunol. 2021 Sep 1;12:713799. doi: 10.3389/fimmu.2021.713799. Figure 1. Tiglylcarnitine as Key Factors in liver-joint axis. A The cluster dendrogram of co-expression genes and modulexis.es Collagen-Induced Arthri B The shared metabolites between the blue module of liver, the black module of plasma, and yellow modules of synovial fluid. C The chemical structures of Tiglylcarnitine. Acknowledgements Funded by Natural Science Foundation of Shandong Province (ZR2021QH329). Disclosure of Interests None declared